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Visual neural performance for chromatic displays.

Various subjective procedures have been used in the past to examine the visual disorders and ocular symptoms often associated with prolonged usage of Video Display Units (VDU's). We examined visual neural performance for VDU stimuli which differed in size (14, 21, or 28 min arc), chromaticity (white, red, green, or blue), and retinal clarity, by transient pattern visually evoked potentials (t-p VEP's). Such information could prove useful in the design of electro-optical display systems that optimize visual neural performance and minimize ocular fatigue. Stimuli consisted of "monochromatic" (W, R, G, or Blue on black) and "multichromatic" (Blue/R, Blue/G, and R/G) checkerboards with brightness-matched chromatic elements displayed on a high resolution RGB monitor at 40 and 80 cm. The ambient lighting level was 54 lux. Group-averaged amplitudes and implicit times of t-p VEP's from 20 visually normal subjects indicated a differential neural response across target colors and three experimentally induced levels of blur. For monochromatic stimuli, the Blue/Black targets elicited t-p VEP's with the lowest amplitude, longest implicit time, and greatest sensitivity to optical defocus. Increasing the target element size reduced the VEP sensitivity to defocus across all colors except red. For multichromatic targets, Red/Green targets elicited the most vulnerable t-p VEP's. Several optical and neural explanations are given to explain these results. Implications for VDU designs are presented.

Accommodation, Ocular↗

Approximating ocular surfaces by generalised conic curves.

Most of the optical models of the human eye use simple conic functions to represent its individual components such as corneal surfaces and the surfaces of the crystalline lens. Although a conic function provides an acceptable approximation for most anatomical eye surfaces, it also leads to a simple optical analysis of the whole eye system. To fill the gap between the classical use of conic surfaces and the use of more sophisticated functions that often invoke numerically expensive procedures in the optical analysis, a functional generalisation of the conic curve is proposed. A detailed derivation of the generalised conic function is presented for a two-dimensional (meridional) case. This is followed by a three-dimensional surface approximation. Examples are given in which the superiority of the proposed approximation over a classical conic function as well as the hyperbolic cosine approximation is evident. In particular, it is shown that for an average total corneal profile, the proposed generalisation results in a residual height error that is of an order smaller than those achieved with the conic and hyperbolic cosine approximations. In conclusion, the proposed generalised conic function can be a useful tool in eye modelling, where the simplicity of expression is often desirable.

Accommodation, Ocular↗

Pre-term delivery and subsequent ocular development. A 7-10 year follow-up of children screened 1982-84 for ROP. 1) Visual function, slit-lamp findings, and fundus appearance.

An ophthalmic follow-up comprised 88 children aged 7-10 years who had regular screening for retinopathy of prematurity (ROP) after their pre-term delivery 1982-84. Mean values of birth weight and gestational age in the 88 were 1467 g and 31 weeks. Out of 28 with early evidence of ROP four had progressed to bilateral blindness; the remaining 24 had at least a corrected visual acuity of 0.4 at disposal. The corrected median binocular acuity for all 88 was 0.95; however, the cumulated frequency curve was significantly below a previously stated norm in full-terms. The same conclusion was valid for single eye vision. Within the material, the visual score of the 28 with early ROP was significantly lower than in the remaining 60 subjects. Ophthalmoscopy often showed tortuosity of vessels, but no specific central retinal or optic nerve lesion to explain the slight general depression of visual acuity, and opacities of media contributed in only two subjects. It is concluded, that very preterm delivery generally influences the potential for developing full visual acuity, also in individuals without evidence of early ROP. Evidence of CNS-damage negatively influenced visual acuity score.

Accommodation, Ocular↗

Biometric measurements of the eyes in teenagers and young adults with Down syndrome.

PURPOSE: To examine ocular biometric variables in subjects with Down syndrome. METHODS: In a population-based study we have compared ocular biometric variables in a group of 47 individuals with Down syndrome (20.0+/-3.9 years) with 51 control subjects (21.0+/-4.6 years). RESULTS: A thinner cornea (0.48+/-0.04 mm vs. 0.55+/-0.03 mm, p<0.001) and higher keratometry values (46.39+/-1.95 D vs. 43.41+/-1.40 D, p<0.001) were found in the Down syndrome group than in the control group. Oblique astigmatism was commonly found in the Down syndrome individuals, showing a strong right-left specificity (right eyes' axes in the 135 degrees -meridian, left eyes' axes in the 45 degrees -meridian). The lens was thinner (3.27+/-0.29 mm vs. 3.49+/-0.20 mm) and the calculated lens power was weaker (17.70+/-2.36 D vs. 19.48+/-1.24 D) in the Down syndrome group than in the control group (p<0.001 in both cases). CONCLUSIONS: Thinning of the corneal stroma may account for the steeper cornea and the high frequency of astigmatism in Down syndrome due to lower corneal rigidity. It may also be of etiological importance to the increased incidence of keratoconus in Down syndrome.

Accommodation, Ocular↗

Dietary restriction of adult male rhesus monkeys: design, methodology, and preliminary findings from the first year of study.

Dietary restriction (DR) retards aging processes and extends maximum life span in rodents and in simpler animals. We initiated a study in 30 adults (8-14 years old) male rhesus monkeys to determine whether or not aging processes are retarded by adult-onset DR in a primate species and herein report results from the experiment's first year. Following a 3-6 month period when baseline data were obtained, 15 animals were assigned to a control group and given free access to a semipurified diet for 6-8 hours per day. The other 15 monkeys were fed the same diet but at 70% of their baseline intake levels predetermined individually. The animals are being evaluated semi-annually for body size and composition, physical activity, metabolic rate, glucose tolerance and insulin sensitivity, hematologic indices, immunologic function, and fingernail growth. Ocular function is assessed annually. The preliminary observations after one year are: (a) all monkeys appear to be in excellent health; (b) average body weights for controls increased by 9% while monkeys on DR did not gain weight; (c) monkeys on DR have less body fat than do control monkeys, whereas the amount of lean body mass has not been significantly influenced by DR; (d) there was a small but statistically significant reduction in physical activity for monkeys on DR relative to controls; and (e) DR has not overtly influenced the other measures. Control monkeys gradually reduced their voluntary levels of food intake during the first year of study, and food allotments to DR monkeys are being adjusted accordingly in order to reinstate the intended 30% difference between groups. These early data indicate that DR can be safely instituted in adult monkeys, but that longer term and/or more severe DR is required to determine if it is capable of influencing age-sensitive indices in long-lived primates.

Accommodation, Ocular↗

Reduction of pupil size and halos with minus lenses after laser in situ keratomileusis.

PURPOSE: To evaluate the amount of miosis induced by over-minused lenses and to assess subjective reduction of halos following laser in situ keratomileusis (LASIK) with such lenses. METHODS: Part I: Infrared pupil diameter was assessed in 14 patients who had not had ocular surgery. The accommodative/miotic reflex was stimulated with concave trial lenses in -1.00-D increments up to -4.00 D while viewing the 20/40 acuity line. Part II. Subjective halos around a distant light were assessed in 14 patients following LASIK for myopia, with and without a -1.00-D lens over manifest refraction. RESULTS: Part I: 100%, 79%, and 64% of patients clearly saw the 20/40 line with a -1.00-D lens, -2.00-D lens, and -3.00/-4.00-D lens, respectively. Mean pupil diameter decreased by 0.2 mm with the -1.00-D lens (P = .02), 0.5 mm with the -2.00-D lens (P = .003), 0.9 mm with the -3.00-D lens (P = .008,), and 1.1 mm with the -4.00-D lens (P = .008). Part II: 11 of 14 patients (79%) noticed a decrease in the size of the halo (30% average reduction) when over-minused by -1.00 D. CONCLUSIONS: Pupil diameters and halos decreased with a -1.00-D overcorrection in patients following LASIK. Patients with pupil-dependent night halos after LASIK may benefit from mildly over-minused lenses.

Accommodation, Ocular↗

Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs.

Deviations of the position of the eye in the roll plane, ocular torsion (OT), and the subjective visual vertical (SVV) were systematically studied in 111 patients with acute vascular brainstem lesions. Of the 111 patients, 104 (94%) showed a direction-specific pathological tilt of the static SVV in our series. Seventy-one (83%) of 86 patients exhibited pathological static OT of one (47%) or both (36%) eyes. OT and SVV tilts are therefore sensitive signs in acute unilateral brainstem disorders. Measurements of SVV and OT may prove to be useful components of the neuro-ophthalmological evaluation. With respect to the directions of pathological tilt, SVV and OT are generally in the same direction. Based on neuroimaging, we conclude that all unilateral brainstem lesions caudal to the upper pons cause ipsiversive OT of one or both eyes, with concurrent ipsiversive tilts of SVV adjustments; all lesions rostral to this pontine level cause contraversive tilts of OT and SVV. Evidence is presented that pathological tilts of OT and SVV are secondary to a dysfunction of the tonic bilateral vestibular inputs that stabilize the eyes and head in normal upright position in the roll plane and dominate our perception of verticality.

Accommodation, Ocular↗

Bilateral posterior fixation sutures on the medial rectus muscles for correction of nonaccommodative esotropia with infantile onset criteria.

BACKGROUND: Bilateral posterior fixation sutures on the medial rectus muscles can be used in the management of nonaccommodative esotropia with criteria indicative of infantile onset. The postoperative results of posterior scleral fixation of bilateral medial rectus muscles on ocular motility and the angle of esotropia in different directions of gaze, as well as on the near point of convergence, have been studied. METHODS: Twenty-six patients suffering nonaccommodative esotropia of the infantile onset type, showing variable angles, adduction overshooting, and esodeviation, which had started within the first year of life, were examined. The angle of esotropia was measured at near, distance, and in the different directions of gaze. All patients underwent post-equatorial scleral fixation of both medial rectus muscles at 12 mm to 14 mm from the insertion, depending on the preoperative angle of esotropia. RESULTS: With the alternate prism cover test, 20 patients (76.9%) showed an angle <10 prism diopters (delta) in the primary position, as well as in the different directions of gaze. Fifteen of the 20 patients (57.7%) even showed simultaneous perception at near and at distance with Bagolini's striated glasses. Six patients were under-corrected. CONCLUSIONS: Bilateral posterior fixation of the medial rectus muscles is a good procedure to correct the angle of esotropia in patients who meet the following criteria: essential infantile esotropia, showing overacting medial rectus muscles, variable angles, and nonaccommodative convergence excess.

Accommodation, Ocular↗

Optical correction of induced axial myopia in the tree shrew: implications for emmetropization.

PURPOSE: To determine whether an active emmetropization mechanism is involved in the recovery from axial myopia through the use of a mammalian model of refractive development. Specifically, we sought to establish whether the emmetropization mechanism is visually guided by the level of clarity of the image falling on the retina, or if recovery is driven by a mechanism sensitive to abnormal eye shape. METHODS: Young tree shrews had axial myopia induced by monocular deprivation (MD) of pattern vision and then the myopic eye was either: (1) accurately corrected with a negative lens or (2) had a zero-powered lens placed in front of it. Their emmetropization response was monitored, both through the use of ocular refractive and biometric measures, as well as through the assessment of scleral dry weight and glycosaminoglycan synthesis, as indicators of scleral metabolism. RESULTS: Corrective lenses prevented recovery from induced myopia (-6.8 +/- 0.7 D after 5 days MD vs. -6.6 +/- 0.6 D after 5 days of lens wear), whereas animals fitted with zero-powered lenses displayed near full recovery from the induced myopia (-6.6 +/- 0.6 D vs. -1.7 +/- 0.3 D). Significant reductions in scleral dry weight (-4.6 +/- 1.3%) and glycosaminoglycan synthesis (-28.6 +/- 7.3%) were found in the posterior sclera of animals wearing corrective lenses. Conversely, animals wearing zero-powered lenses displayed elevated levels of glycosaminoglycan synthesis (+62.3 +/- 11.1%) in conjunction with scleral dry weights that did not differ significantly between treated and fellow control eyes (-1.5 +/- 2.6%). CONCLUSIONS: Accurate correction of induced axial myopia prevents the refractive, biometric and scleral metabolic responses that are normally observed in tree shrew eyes recovering from induced myopia. These findings support the hypothesis that recovery is driven by an active emmetropization response dependent on the clarity of image falling on the retina and not by a mechanism that is sensitive to abnormal eye shape.

Accommodation, Ocular↗

High altitude and the eye: a case controlled study in clinical ocular anthropometry of changes in the eye.

Tribal natives of two spatially separate districts of Lahaul-Spiti (mean altitude = 3300 m) and Kinnaur (mean altitude = 1,700 m) in the Himalayan state of Himachal Pradesh have lived for centuries as closed isolated groups, marrying within the local community up to the recent past. Studies on highland natives in the Andes have shown differences in chest diameters, lung volumes, hematocrit, and the like, in those living at high altitudes. We wanted to study whether stay at high altitude for generations confers any change in the ocular anthropometry. No study of this nature is available in the literature. We studied the ocular parameters using Snellen's charts, Standard Royal-Air-Force Rule, A-2,500 Sonomed A-Scan, Goldmann's aplanation tonometer, and S-7,000 Autorefractometer on 50 healthy volunteers at the Indira Gandhi Medical College Out Patient Department at Shimla (mean altitude = 2,100 m). Those living at higher altitudes in Lahaul-Spiti [LS] (n = 10) had significantly wider nose bridge width (p < 0.05); inter-inner canthal distance [IICD] (p < 0.05); inter-outer canthal distance [IOCD] (p < 0.05); and interpupillary distance [IPD] (p < 0.05) than the group living at Kinnaur (n = 40) at lower elevation. The LS group also had narrower palpebral fissure length in the vertical dimension (p = 0.05) and a lower IOP (p = 0.002) than the Kinnaur group. The axial length, lens thickness, and anterior chamber depth were comparable in the two groups. It appears that the eye and its adnexa respond to hypoxia, ultraviolet radiations, and persistent snow cover at high altitude by altering its anthropometry in a subtle but discernible manner. This was a hitherto unexplored area in the literature. Further studies to elucidate and substantiate the findings of the study are indicated.

Accommodation, Ocular↗

Differences between objective and subjective refractions after radial keratotomy.

BACKGROUND: In patients who are free of pathology, automatic refractions have shown close agreement with the subjective refractions. Clinical experience indicated that the normally strong relationship between objective and subjective refraction is significantly weakened as a result of radial keratotomy. METHODS: Seventy-two patients were refracted before and after surgery, objectively with a Humphrey Model #510 autorefractor and subjectively using a binocular refraction procedure without cycloplegia. All patients were free of ocular disease and had preoperative myopia ranging from -1.00 to -9.00 diopters as determined by the subjective spherical equivalent. RESULTS: The results indicated that the preoperative difference between the mean spherical automatic and subjective refractions was a clinically acceptable 0.25 diopter. However, postoperatively, there was a statistically significant difference of 1.25 D with the automatic refractor determining more myopic refractions. Subsequent analysis revealed that the age of the patient had a direct bearing on this finding with patients less than 40 years of age showing more minus in the automatic refraction than patients 40 years and older. CONCLUSIONS: The postoperative discrepancy between the two refractions may be explained by induced optical aberrations and may contribute towards the visual fluctuations experienced by radial keratotomy patients. It is postulated that the inconsistency in refractive determination is due to optical distortion since the age dependence of this effect may be related to the reduction of pupil size that occurs with aging. In the radial keratotomy patient, the practitioner is faced with a more complex and uncertain refraction that may vary according to refractive procedures used and other factors such as pupil size.

Accommodation, Ocular↗

Axial growth and changes in lenticular and corneal power during emmetropization in infants.

PURPOSE: To evaluate the contribution made by the ocular components to the emmetropization of spherical equivalent refractive error in human infants between 3 and 9 months of age. METHODS: Keratophakometry in two meridians was performed on 222 normal-birthweight infant subjects at 3 and 9 months of age. The spherical equivalent refractive error was measured by cycloplegic retinoscopy (cyclopentolate 1%). Anterior chamber depth, lens thickness, and vitreous chamber depth were measured by A-scan ultrasonography over the closed eyelid. RESULTS: Both the mean and SD for spherical equivalent refractive error decreased between 3 and 9 months of age (+2.16 +/- 1.30 D at 3 months; +1.36 +/- 1.06 D at 9 months; P < 0.0001, for the change in both mean and SD). Average ocular component change was characterized by increases in axial length, thinning, and flattening of the crystalline lens, increases in lens equivalent refractive index, and decreases in lens and corneal power. Initial refractive error was associated in a nonlinear manner with the change in refractive error (R(2) = 0.41; P < 0.0001) and with axial growth (R(2) = 0.082; P = 0.0005). Reduction in hyperopia correlated significantly with increases in axial length (R(2) = 0.16; P < 0.0001), but not with changes in corneal and lenticular power. Decreases in lenticular and corneal power were associated with axial elongation (R(2) = 0.40, R(2) = 0.12, respectively; both P < 0.0001). CONCLUSIONS: Modulation in the amount of axial growth in relation to initial refractive error appeared to be the most influential factor in emmetropization of spherical equivalent refractive error. The associations between initial refractive error, subsequent axial growth, and change in refractive error were consistent with a visual basis for emmetropization. The cornea and crystalline lens lost substantial amounts of dioptric power in this phase of growth, but neither appeared to play a significant role in emmetropization.

Accommodation, Ocular↗

Contrast sensitivity function and ocular higher-order wavefront aberrations in normal human eyes.

PURPOSE: To investigate the relation between contrast sensitivity function and ocular higher-order wavefront aberrations in normal human eyes. STUDY DESIGN: Prospective observational case series. PARTICIPANTS: Three hundred seven eyes of 161 normal subjects, ranging in age from 15 to 60 years (30.9+/-8.0 [mean +/- standard deviation]). METHODS: Ocular higher-order aberrations were measured for a 4-mm pupil using the Hartmann-Shack wavefront analyzer. The root-mean-square of the third- and fourth-order Zernike coefficients was used to represent comalike and spherical-like aberrations, respectively. We measured contrast sensitivity, low-contrast visual acuity (VA), and letter contrast sensitivity. From the contrast sensitivity data, the area under the log contrast sensitivity function (AULCSF) was calculated. Pupil diameter in a photopic condition was recorded using a digital camera. RESULTS: Multiple linear regression analysis revealed that comalike aberration (P = 0.002) was significantly associated with AULCSF, but spherical-like aberration (P = 0.200), age (P = 0.185), and photopic pupil diameter (P=0.252) were not. Comalike aberration showed a significant correlation with low-contrast VA (P<0.001), but spherical-like aberration (P = 0.293), age (P = 0.266), and pupil diameter (P = 0.756) did not. Comalike aberration was found to be significantly associated with letter contrast sensitivity (P<0.001), but spherical-like aberration (P=0.082), age (P = 0.370), and pupil diameter (P = 0.160) were not. CONCLUSIONS: In normal human eyes, comalike aberration of the eye significantly influences contrast sensitivity function.

Accommodation, Ocular↗

The change in ocular refractive components after cycloplegia in children.

PURPOSE: To study the change in ocular refractive components after cycloplegia in children. METHODS: Anterior chamber depth, lens thickness, vitreous chamber length, and ocular axial length were measured in 135 Chinese children (270 eyes) before and after cycloplegia. The corneal curvatures of 136 selected eyes were studied before and after cycloplegia with a computerized video keratoscope. RESULTS: Anterior chamber depth increased (P <.001) while both lens thickness and vitreous chamber length decreased (P <.001) significantly after cycloplegia regardless of the refractive state. However, axial length increased in hyperopic eyes (P =.027) but decreased in myopic eyes (P =.008) after cycloplegia. Mean corneal power of zones 3 mm (MD3, P =.009) and keratometer K1 readings increased (P =.025) in hyperopic eyes, while MD3 (P =.033), K1 (P =.039) and K2 (P =.003) readings decreased in myopic eyes significantly after cycloplegia. Similarly, mean corneal power of zones 5 mm and 7 mm in myopic eyes decreased dramatically (P <or=.001). In both hyperopic and myopic eyes, there was significant difference (P <.001) in the mean value of the upper and lower half of the vertical meridian, as well as the medial and lateral half of the horizontal meridian, respectively. CONCLUSIONS: Cycloplegia has a great influence on various refractive components in children. There is asymmetry of the corneal surface within the same horizontal or vertical meridian.

Accommodation, Ocular↗

Gaze position corrective eye movements in normal subjects and in patients with vestibular deficits.

Eye movements in response to high-acceleration head rotations (thrusts) in the horizontal plane from patients with unilateral (UVD) or bilateral vestibular loss (BVD) were recorded. The rapid, gaze-position corrections (GPCs) that appeared when vestibulo-ocular reflex (VOR) slow phases were undercompensatory were characterized. For comparison, eye movements from normal subjects who were asked to generate saccades in the direction opposite head rotation (in the same direction as slow phases) were recorded. This normal-subject model produced responses with spatial and temporal characteristics similar to those from GPCs in patients as follows: When head rotations were generated actively, compared with passively, gaze-position errors and corresponding GPCs were smaller and occurred earlier. During passively generated head thrusts, GPCs still occurred when head rotations were made in total darkness, though their accuracy decreased as the requirement for maintaining gaze on a specific location in space was relaxed. Time of onset of GPCs was not rigidly tied to head kinematics (peak velocity or peak acceleration). Speeds of GPCs, however, were lower than speeds of similar-sized, head-fixed saccades. Finally, during passive and active head thrusts in patients, sustained, high-frequency (20 to 30 Hz) oscillations that appeared as tiny saccades were occasionally observed, one immediately following the other, resembling a compensatory slow-phase response. Taken together, the results suggest that one strategy for overcoming a VOR deficit is to enlist the saccadic system to produce an oculomotor response that is required to compensate for head rotation. This response may come in the form of high-velocity GPCs or smaller-amplitude oscillations.

Accommodation, Ocular↗

Scanning laser ophthalmoscope fundus cyclometry in near-natural viewing conditions.

BACKGROUND: For a better understanding of motor and sensory adaptations in cyclodeviations, subjective and objective ocular torsion have to be measured under the same conditions. The search coil technique and videooculography allow natural viewing but only assess relative cycloduction, the dynamics of torsion over a short period of time. Cycloposition, on the other hand, can be measured by analysing the position of the foveola relative to the optic disc with fundus photographs but only in nonphysiological viewing. The aim of the study was to develop a technique that allows natural viewing conditions during fundus cyclometry. METHODS: The scanning laser beam of the SLO was deflected by 90 degrees with a semitransparent mirror in front of the patient's eyes. The patient was able to look through the semitransparent mirror with both eyes into the room, e.g. at Harms' tangent screen. The infrared SLO images the central retina via the mirror through the undilated pupil. Digital image analysis quantifies the cycloposition of the eye. Controlled head movements while fixating the centre of Harms' tangent screen allow measurements in reproducible gaze positions. RESULTS: The semitransparent mirror reduces SLO image brightness, but image quality is sufficient for cyclometry after contrast enhancement. The laser light can be vaguely perceived by the patient but does not interfere with natural viewing. Reproducibility of the measurement is within +/- 1 degree SD. CONCLUSION: Our modification of SLO fundus cyclometry allows direct measurements of cycloposition in natural viewing conditions. This opens a new field for investigations of cyclodeviations and their sensory and motor adaptations.

Accommodation, Ocular↗

Physiological strategies for emmetropia.

PURPOSE: To identify relationships among age-independent ocular biometric variables which contribute to ocular refraction in adult human eyes, and to identify differences in those relationships between emmetropes and ametropes. METHODS: Manifest refraction (DRS methodology), corneal refractive power (keratometry), and axial anterior segment (anterior cornea to posterior lens), vitreous cavity (posterior lens to anterior sclera) and total globe (anterior cornea to anterior sclera) length (A-scan ultrasonography) were determined in 185 unaccommodated right eyes of adult humans aged 18 to 70 years. There were 136 emmetropes with absolute refractive error < or = 2.0 diopter, and 49 ametropes (47 myopes, 2 hyperopes) with absolute refractive error of 2.25-11.0 diopters. RESULTS: Refraction decreased significantly with increasing globe and vitreous cavity length in emmetropes and ametropes. Anterior segment length was also significantly negatively correlated with refraction in emmetropes, but not in ametropes. Corneal refractive power was not correlated with refraction in either group, but decreased significantly with increasing globe length in both, more strongly in emmetropes. Globe and vitreous cavity length were significantly positively correlated in both groups, more strongly in ametropes. Anterior segment length increased significantly with increasing globe length in emmetropes but not in ametropes. Anterior segment length decreased significantly with increasing vitreous cavity length in ametropes but not in emmetropes. CONCLUSION: These findings indicate an "inflatable anterior segment" as well as the classic "inflatable globe" mechanism of emmetropization. This newly described anterior segment mechanism involving increased separation between the cornea and the lens with increasing globe size appears to be absent in adult human myopia.

Accommodation, Ocular↗

Eye shape in emmetropia and myopia.

PURPOSES: To determine axial, vertical, and horizontal eye dimensions in myopic and emmetropic eyes by using magnetic resonance imaging (MRI) and to relate these to different ocular expansion models of myopia development. METHODS: The internal length (cornea to retina), height and width (both retina to retina) were measured in emmetropic and myopic eyes (up to -12 D) of 88 participants aged 18 to 36 years. Participants were positioned supine in a clinical MRI scanner. The fixation target was imaged straight ahead of the subject by an overhead 45 degrees inclined mirror. Eye images were acquired with a 7.5-cm receive-only radio frequency surface coil. Axial (horizontal through middle of eye) and sagittal (vertical through visual axis) sections were taken with a T(1)-weighted fast spin-echo sequence. RESULTS: With an increase in myopic refractive correction, myopic eyes became much larger in all three dimensions, but more so in length (0.35 mm/D, 95% confidence interval [CI] 0.28-0.40) than in height (0.19 mm/D, 95% CI 0.09-0.29) and more so in height than in width (0.10 mm/D, 95% CI 0.01-0.20). Based on height and length dimensions, 25% and 29% of myopic eyes exclusively fitted global expansion and axial elongation models, respectively. Based on width and length dimensions, 17% and 39% of myopic eyes exclusively fitted the global expansion and axial elongation models, respectively. CONCLUSIONS: Although there are considerable individual variations, in general myopic eyes are elongated relative to emmetropic eyes, more in length than in height and even less in width. Approximately a quarter of the myopic participants fitted each of the global expansion or axial elongation model exclusively. The small proportions are due primarily to the large variability in the dimensions of emmetropic eyes.

Accommodation, Ocular↗